The present invention relates to a newly developed tissue excision and cutting apparatus and resection forceps for cutting off a part of human tissue as a sample piece for such a diagnosis in laparoscopic surgery or the like.
A tissue excision and cutting apparatus for surgical operation has been used together with a forceps and a laparoscope and various kinds of such related apparatuses have been proposed till up now.
One example has a cylindrical resection blade rotated by a motor in a guide cylinder to be inserted into a trocar, and forceps for grasping an objective tissue inserted into the resection blade.
FIGS. 20a to 20c show how to use the tissue excision and cutting apparatus of prior art and the forceps to be combined therewith.
A tissue excision and cutting apparatus 101, as shown in FIG. 20a, comprises a main body 103 with grip portion, a guide cylinder 102a to be inserted into a trocar (not shown), and a resection blade 102b with a blade at its tip end which is driven to be rotated in the guide cylinder 102a by a motor (not shown).
On the other hand, a forceps 104 to be combined with the tissue excision and cutting apparatus 101 in such a manner as shown in FIG. 20(a) has a main axis 104a with at its tip end a clamp 104b which can be opened and closed by manual operation of one hand.
According to such a tissue excision and cutting apparatus 101, while observing around the tip end of the tissue excision and cutting apparatus 101 inserted into the trocar by a laparoscope (not shown), a tissue A may be grasped by the clamp 104b of the forceps 104 by approaching the forceps to the tissue A, after then the forceps 104 is withdrawn into the guide cylinder 102a in the state of grasping tissue A to bring it into contact with the blade of rotating resection blade 102b, by which a part of tissue A can be cut off as a sample piece (See FIGS. 20a to 20c).
FIG. 21 shows a tissue excision and cutting apparatus according to the prior art in which a forceps and a resection blade are integrated wherein FIG. 21a illustrates a front view of its partial vertical section and FIG. 21b its rear view.
A tissue excision and cutting apparatus 111, as shown in these figures, comprises a tissue cutting resection blade 112 composed of a cylindrical blade 112b and a guide cylinder 112a, a main body 113 with a grip 113a and holing portion 113b for the forceps 114, a forceps 114 itself, a forceps withdrawing mechanism 115 with a trigger 115a for finger operation, a forceps open-close mechanism 116 with a finger operation part 116a, and a motor 118 for rotating the blade 112b. 
In this figure, turning operational direction of the open-close finger operation part 116a is shown as an arrow corresponding to open and close operations of the clamp 114b wherein opening direction is shown as an actual line and closing direction is shown as a dotted line, whereas sequential pulling operation of the trigger 115a is also shown by an arrow corresponding to with drawing operation of the forceps.
According to such a tissue excision and cutting apparatus 111, operating a laparoscope (not shown) by a left hand while observing objective tissue with the apparatus 111 held by a right hand, and advancing the forceps 114 to the objective tissue, where the open-close operation part 116a is turned in a closing direction by a thumb C of the right B hand as shown in a dotted line in FIG. 21(b), thus enabling to grasp the objective tissue by the clamp 114b of the forceps 114.
After grasping the tissue A, the motor 118 is driven to rotate resection blade 112b and the trigger 115a is repeatedly operated by a forefinger D of the right hand B, thereby cutting off tissue A by the resection blade 112b in cylindrical shape. And the apparatus is so constructed that tissue thus grasped is prevented from dropping out even if the thumb C is departed from the open-close operation part 116a. 
According to the tissue excision and cutting apparatus 111 described above, comparing to the one shown in FIG. 20, the forceps can be operated by a thumb C and retraction can be executed by a forefinger D, with its main body held only by one hand, thus enabling another hand to operate a laparoscope or the like.
In any of above-mentioned tissue excision and cutting apparatus of the prior art, tissue is drawn into a guide cylinder and cut off therein while rotating a resection blade. Therefore, in such a method, tissue would not be sharply or finely cut off.
In other words, in such a method tissue is apt to be torn off and partly broken when tissue is drawn into the guide cylinder to be cut off so that it makes difficult to surely and sharply cut off the tissue, or the part of tissue could not be cut off well.
In addition, in such a prior tissue excision and cutting apparatus, the resection blade is exposed from a guide cylinder when tissue is cut off. Therefore, there would be a fear that organ not to be cut off or an end-bag (explained hereinafter referring to FIG. 6 to FIG. 9) used for laparoscopic surgery happens to be damaged.
The present invention has proposed to solve the above-mentioned problems.
Accordingly, it is the primary object of the invention to provide a tissue excision and cutting apparatus which can finely and sharply cut off an objective tissue and a resection forceps to be used for the apparatus.
It is another object to provide a tissue excision and cutting apparatus which doesn""t have such a fear and a forceps used for the apparatus.
In the present invention, a tissue excision and cutting apparatus used by inserted into a trocar for cutting off a part of tissue for sampling in laparoscopic surgery or the like comprises a resection blade with an inner hollow cylinder body having a cutting blade at its tip end, and a forceps for cutting off a part of tissue to be cut off as a sample piece.
The forceps has at its tip end a clamp for grasping a part of tissue which has a movable jaw capable of opening and closing and is joined to a fixed jaw vertically provided with a chopping block piece, an open-close mechanism with a hand operation part for opening and closing by manual operation, and a longitudinal penetrating passage into which the resection blade is inserted and moves back and forth therein.
The tissue excision and cutting apparatus is constructed such that resection blade and the forceps are combined with when using it.
The apparatus is characterized in that the penetrating passage of the forceps is constructed such that the resection blade is inserted into and moves back and forth therein and one of the clamp of the forceps is a fixed jaw provided at its chip end with a chopping block piece servicing as a stopper plate for the blade of resection blade. The chopping block piece functions as the so called chopping block for the blade of the resection blade, thereby enabling to cut off an objective tissue by pressing it in such manner as not in the prior pull-in-type tissue excision and cutting apparatus, thus any of tissues can be finely and surely cut off.
In addition, in the apparatus, other organ or an endo-bag isn""t damaged because the resection blade is contained and hidden in the clamp of the forceps, thereby achieving safety.
If the shape of a part where the resection blade is contacted is contrived, tissue can be cut off not only by pressing on the resection blade a chopping block piece but also by shearing the resection blade and the chopping block piece. For example, when the chopping block piece is normally formed as such cylindrical shape that it has an inner diameter in which the outer diameter of cylindrical blade of the resection blade is just engaged, tissue can be sheared to be cut off by cylindrical shape, or the chopping block piece and the resection blade.
In other embodiment of the present invention, a tissue excision and cutting apparatus used by inserted into a trocar for cutting off a part of tissue for sampling in laparoscopic surgery or the like comprises a resection blade with an inner hollow cylinder body having a cutting blade at its tip end, and a forceps for cutting off a part of tissue as a sample piece wherein the resection blade is capable of rotating by driving a rotary driving mechanism and the forceps has at its tip end a clamp for grasping a part of tissue to be cut off which has a movable jaw capable of opening and closing and is joined to a fixed jaw vertically provided with a chopping block piece, an open-close mechanism with a hand operation part for opening and closing by manual operation, and a longitudinal penetrating passage into which the resection blade is inserted and moves back and forth therein.
According to such a tissue excision and cutting apparatus, the resection blade is capable of rotating by a rotary driving mechanism comprised of a motor by operating a switching means such a foot pedal or the like. Therefore, tissue can be cut off and sampled more smoothly.
Further in another tissue excision and cutting apparatus of the present invention, the hand operation part of the forceps is constructed such that it can be held by one hand and the movable jaw can be operated by the one hand. Therefore, the apparatus is very convenient for handling because forceps can be held and manually operated by one hand while the resection blade can be operated by another hand.
Further in other embodiment of the present invention, a chopping block piece of the resection blade is formed with a blade receiving surface on which the whole circumference of the blade contacts.
According to such construction, cut end of tissue by the resection blade can be done sharply and finely by pressing the blade of the resection blade onto the surface.
In still another embodiment of the invention, a sealing mechanism for airtightly sealing the penetrating passage is further provided for isolating ventilation of the open air even when the forceps is inserted into the passage or is pulled out from the passage.
According to such construction, outer air is prevented from entering in abdominal cavity or the endo-bag through the penetrating passage or especially pneumoperitoneum gas is prevented from leaking out when being filled in the endo-bag.
In other embodiment of the invention, the sealing valve mechanism is detachable and exchangeable for the penetrating passage.
Therefore, used it is very useful for preventing contamination or contagion since it can be easily exchanged every time the forceps is used.
In still other embodiment of the invention, the resection blade further comprises a sealing rod for airtightly sealing the inner of the hollow cylinder body and a push shaft for outward extruding a part of tissue cut off and held in the hollow cylinder body as a sample piece which is airtightly inserted into the cylinder body from a push hole provided at the rear end of the sealing rod.
According to such tissue excision and cutting apparatus, the inner of the hollow cylinder body of the resection blade can be kept airtight by the sealing rod and the push rod so that the tissue cut off as a sample piece is prevented from dropping out from the hollow cylinder body even when the tip of the resection blade is directed downward for extracting the resection blade from the forceps. And the cut off tissue held in the hollow cylinder body can be easily extruded by releasing the sealing and pushing the push shaft into the inner of the hollow cylinder after when the resection blade is moved to a predetermined place.
In other embodiment of the invention, the resection blade further comprises a sealing push rod airtightly inserted into the hollow cylinder body from an insertion opening provided at the rear end of the cylinder body, and a simple suction means which is connected to the sealing push rod for keeping the inner portion of the hollow cylinder body airtight to hold a part of tissue cut off by the resection blade.
According to such tissue excision and cutting apparatus, the cut off tissue as a sample piece held in the hollow cylinder body can be surely prevented from dropping out by effecting sucking force by means of the simple suction means. Further, the cut off tissue held in the hollow cylinder body can be easily extruded outward by releasing the sucking force and pushing a sealing push rod into the hollow cylinder body after moving to a predetermined place.
In still further other embodiment of the tissue excision and cutting apparatus, the resection blade further comprises a sealing suction rod into which a sealing suction mechanism is incorporated and a push rod for outward extruding the tissue cut off and held in the hollow cylinder body as a sample piece wherein the sealing suction rod airtightly seals the inner portion of the hollow cylinder and holds the tissue by keeping airtight, and the push rod is airtightly inserted in the hollow cylinder body from a push hole provided at the rear end of the sealing suction rod.
According to such tissue excision and cutting apparatus, the cut off tissue as a sample piece held in the hollow cylinder body can be surely prevented from dropping out by effecting sucking force by means of the simple suction means. Further, the cut off tissue held in the hollow cylinder body can be easily extruded outward by releasing the sucking force and pushing a sealing push rod into the hollow cylinder body after moving to a predetermined place. In addition, it is more convenient to handle it because sealing suction rod and a sealing suction mechanism are incorporated into the resection blade together.
In other embodiment of the tissue excision and cutting apparatus, the resection blade further comprises a suction sampling collecting means which is detachably connected to the rear end of the hollow cylinder body for sucking and collecting a part of tissue cut off as a sample piece by the resection blade.
According to such a tissue excision and cutting apparatus, since the suction sampling collecting means sucks to collect by effecting active suction force instead of keeping airtight in the hollow cylinder body, the cut off tissue can be easily and sequentially suck and collected in the sampling collecting means.
In other embodiment of the tissue excision and cutting apparatus, a holding craw similar to thorn is provided in inner surface adjacent to the tip end of resection blade for preventing dropping out the tissue cut off as a sample piece by peripherally and partially holding it.
In the present invention, a forceps used together with the present apparatus has been also proposed, wherein the forceps comprises a clamp provided at a tip end of the forceps and having a movable jaw capable of opening and closing which is joined to a fixed jaw provided with a chopping block piece, an open-close mechanism with a hand operation part for opening and closing the movable jaw, and a longitudinal penetrating passage into which the resection blade is inserted and moves back and forth therein.
Such a forceps is the one used for the tissue excision and cutting apparatus of the present invention, and accordingly a part of tissue can be finely and surely cut off.
When such a forceps is used, any kinds of resection blade which are rotatable or not rotatable can be also employed and a chopping block piece may serve as the so called a cutting board.
According to other embodiment of the forceps, the operation part of the forceps is constructed such that it can be held by one hand and the movable jaw can be operated for opening and closing by manual operation of the one hand.
Further in another tissue excision and cutting apparatus of the present invention, the operation part of the forceps is constructed such that it can be held by one hand and the movable jaw can be operated by the one hand. Therefore, the apparatus is very convenient for handling because forceps can be held and manually operated by the same one hand while the resection blade can be operated by another hand.
Therefore, it is easy and convenient to handle such a forceps because it can be opened and closed and held the same one hand with another hand operating a resection blade.
Further in other embodiment of the present invention, a chopping block piece of the resection blade is formed with a blade receiving surface on which the whole circumference of the blade contacts.
According to such construction, a part of tissue grasping by the clamp can be sharply and finely cut off by pressing the blade of the resection blade onto the surface, by which a sample piece of tissue with a sharp cut end can be obtained.
Still another embodiment of the invention, a sealing mechanism for airtightly sealing the penetrating passage is further provided for isolating ventilation of the open air even when the forceps is inserted into the passage or is pulled out from the passage.
According to such construction, outer air is prevented from entering in abdominal cavity or the endo-bag through the penetrating passage and especially pneumoperitoneum gas is well prevented from leaking out when being filled in the endo-bag.
In other embodiment of the invention, the sealing valve mechanism is detachable and exchangeable for the penetrating passage.
Therefore, according to such construction, it is very useful for preventing contamination or contagion since it can be easily exchanged every time the forceps is used.